Objective To compile nursing guidelines for diabetic patients undergoing ultrasound-guided islet transplantation through percutaneous portal vein puncture and catheterisation,providing valuable insights for the care of such patients during the surgical procedure.Methods Between December 2017 to September 2023,a total of 27 patients underwent 44 surgical procedures for ultrasound-guided islet transplantation via percutaneous portal vein puncture and catheterisation at our hospital.Nursing assistance was provided preoperatively,intraoperatively and postoperatively for all the procedures.Results All 27 patients who had undergone 44 surgical procedures successfully went through the ultrasound-guided islet transplantation via percutaneous portal vein puncture and catheterisation.Among the 44 surgical procedures,3(6.8%)resulted in upper abdominal and liver area pain,nausea and vomiting during surgery,8(18.2%)had transient increase of portal vein pressure during transplantation,and 6(13.6%)encountered active bleeding following the removal of the portal vein catheters.None of the patients developed delayed portal vein bleeding or complication such as portal vein thrombosis after the surgery.Conclusions Nursing interventions play a crucial role in ensuring the successful outcomes of ultrasound-guided islet transplantation.Following measures are the keys and they play an important roles in ensuring the smooth completion of ultrasound-guided islet transplantation:preoperatively,carefully assess the condition of recipients and provide them with psychological supports and patient education.Intraoperatively,closely monitor the vital signs,portal vein pressure and blood glucose as well as to prevent complications.Postoperatively,implement the nursing measures to prevent the recipients from postoperative bleeding of portal vein.

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.

【Objective】 To explore the main causes of death and the risk factors for death in maintenance hemodialysis (MHD) patients. 【Methods】 A retrospective study was carried out in 210 MHD patients in The Third Affiliated Hospital of Sun Yat-sen University. Of the 210 patients, 68 dead were designated as the experimental group and the other 142 survivals as the control. Single factor and binary logistic regression analyses were used to investigate the effects of clinical indicators on the prognosis of patients. We further performed subgroup analysis in experimental group, examined the patients died of cardiovascular diseases and those died of non-cardiovascular diseases, and then compared their results of color Doppler echocardiography. 【Results】 The age of the patients was(56.6±16.6) years and 125 of them were male. Compared with those in the control group, the patients in the death group had elder average age, higher rates of complications such as hypertension, diabetes, cardio-cerebro-vascular diseases, lower levels of hemoglobin, albumin, creatinine and uric acid and significantly elevated level of hypersensitive C-reactive protein(P < 0.05). The top three causes of death were cardiocerebro-vascular disease(33 cases, 48.5%), infection(16 cases, 23.5%), malnutrition(8 cases, 11.8%). Logistic regression analysis showed that age, cardio-cerebro-vascular diseases, diabetes mellitus, hypersensitive C-reactive protein and serum creatinine were independent risk factors for death in MHD patients. Subgroup analysis revealed the patients died of CVD diseases had higher incidences of left ventricular hypertrophy and cardiac valve calcification than those died of non-CVD diseases.【Conclusion】Cardio-cerebro-vascular diseases, infection and malnutrition are the main causes of death in MHD patients. Patients died of CVD diseases exhibit significantly higher incidences of left ventricular hypertrophy and cardiac valve calcification compared with those died of non-CVD diseases.

Objective To discuss the application of color-coded digital subtraction angiography (ccDSA) in quantitatively analyzing the instant perfusion changes of hepatic tumors during transcatheter arterial chemoembolization (TACE).Methods The clinical data of 35 patients with hepatocellular carcinoma (HCC) who underwent TACE were reviewed.Before and after TACE,two-dimensional DSA (2D-DSA) was performed by using the same parameters in all patients.The image sequences were post-processed with 2D-ccDSA.On ccDSA images the regions of interest (ROIs) were measured to obtain the time-contrast-intensity (CI[t]) curves as well as the perfusion parameters,including tumor blood supply time (TBST),area under the curve (AUC),contrast-intensity peak (C I-Peak) and maximum upslope (MS),which were used to evaluate the degree of the reduction in direct blood flow and in tumor staining.The relationship between the above parameters and subjective angiographic chemoembolization endpoint (SACE) was analyzed.Results After TACE,the perfusion parameters were significantly different from pre-TACE ones.AUC and CI-Peak values were dramatically decreased.After TACE,TBST slowed a significant delay.The reduction of perfusion about 30％-40％ was equal to SACE grade Ⅲ;the reduction of perfusion about 60％-70％ was equal to SACE grade Ⅳ.Conclusion 2D-ccDSA can be used to objectively and quantitatively evaluate the effect of TACE on the perfusion of hepatic tumors,providing useful indexes for making quantitative assessment of the degree of blood flow stagnation and the reduction of tumor staining.

OBJECTIVE: To observe whether bone marrow mesenchymal stem cell( BMMSC) could be induced by alveolar epithelial cell( AEC) of rats exposed to silica dust or not. METHODS: BMMSCs were isolated and cultivated from 6specific pathogen free healthy male SD rats through bone marrow adherent method. The AECs from other 6 rats randomly selected from the same batch were cultivated by immune adherent purification method. Three rats were treated with 1. 0 m L( 40 g/L mass concentration) of silicosis dust suspension by one time intratracheal injection as silicosis dust exposure model,and the other 3 rats were given 0. 9% sodium chloride solution as normal. Experimental group was the co-culture of BMMSCs and AECs from silicosis dust exposure rats. Control group A was the co-culture of BMMSCs and AECs from normal rats. Control group B was the culture of BMMSCs alone. The morphology changes were observed by the inverted phase contrast microscope at the time points of the 4th and the 8th day. Double immunofluorescence staining using aquaporin 5( AQP5) and surfactant protein C( SP-C) was performed on the treated BMMSCs. The fluorescence staining was observed using the inverted fluorescence microscope( IFM) and laser scanning confocal microscope( LSCM). Integral optical density( IOD) analysis was conducted on fluorescence of 2 kinds of proteins by Image-pro plus 6. 0 graphic analysis software. RESULTS: After the co-culture,the BMMSCs in experimental group and control group A changed from long spindle shape to cubic and polygonal shape,the variation of morphology on day 8 was more obvious than that on day 4,and the change in control group A was less obvious than that of experimental group. There was no obvious morphology change in BMMSCs of control group B. By IFM and LSCM,on day 4 and day 8,the expression of green fluorescence AQP5 and red fluorescence SP-C were all observed in BMMSCs of experimental group and control group A. The BMMSCs of control group B only showed a little green fluorescence expression of AQP5,no expression of red SP-C fluorescence was seen. Both by IFM and LSCM,on day 4 and day 8,the 2 kinds of IOD of BMMSCs in experiment group were higher than those of control group A and B at the same time points( P < 0. 01); the IOD of control group A was higher than that of control group B at the same time point( P < 0. 01). The IOD of experiment group and control group A on day 8 were higher than those on day4 in the same group( P < 0. 01). CONCLUSION: AEC of rats exposed to silica dust can effectively induce BMMSC to be differentiated into AEC.

Objective To explore the effects of dynamic axial compressive strain on the mRNA expression of bone formation related-genes in osteoblasts seeded in 3D silk fibroin scaffolds. Methods In the experimental group, MC3T3-E1 cells were seeded in 3D scaffolds and then subjected to dynamic axial compressive strain (at amplitude of 5% and frequency of 1 Hz, 30 min/day for 20 days), while in the control group, MC3T3-E1 cells were cultured statically without any mechanical stimulation. The gene expression of alkaline phosphatase (ALP), collagenⅠ(COL-Ⅰ), runt-related transcription factor 2 (Runx2), osterix (Osx), osteocalcin (OCN) was detected by real-time PCR. Results Under cyclic axial compressive strain, the Runx2, Osx and COLⅠmRNA levels increased by 280%, 68.9% and 79.6%, respectively, while the ALP and OC mRNA levels also up-regulated by 10.7% and 26.9%, respectively. There were significant differences in mRNA expression of osteogenesis-related genes between the experimental group and control group (P＜0.05). Conclusions Under the stimulation of cyclic axial compressive strain, the osteogenic differentiation of osteoblasts seeded in the silk fibroin scaffolds is promoted, with a significant up-regulation in the mRNA expression of COLⅠ, Runx2, Osx and OCN, which suggests that the stimulation of compressive stress at physiologic magnitude could be one of important mechanisms in promoting fracture healing. This research finding will be important for the clinic application of mechanical stimuli-mediated cell therapy for bone defection.

AIM: To investigate the chemical and bioactive constituents from the stems and leaves of Micromelum integerrimum. METHOD: The chemical constituents were isolated and purified by silica gel, Sephadex LH-20, and HPLC. Their structures were mainly elucidated on the basis of extensive 1D- and 2D-NMR spectroscopy and mass spectrometry. Their cytotoxicity and antimicrobial activities were tested by the SRB and turbidimetric methods, respectively. RESULTS: Two new phenylpropanoids and two known coumarins were obtained, and their structures were identified as microintegerrin A (1), microintegerrin B (2), scopoletin (3), and scopolin (4). All of the compounds were tested for their cytotoxicity against three cancer cell lines (HeLa, A549, and BGC-823) and for antimicrobial activity against the fungus Candida albicans and the bacterium Staphylococcus aureus. CONCLUSION Two new phenylpropanoids 1 and 2 were isolated and identified from the stems and leaves of M. intgerrimum. None of the compounds showed cytotoxic or antimicrobial activity at the tested concentration of 20 μg·mL(-1).
Candida albicans ; drug effects ; Coumarins ; isolation & purification ; pharmacology ; Glucosides ; isolation & purification ; pharmacology ; HeLa Cells ; Humans ; Molecular Structure ; Phenylpropionates ; chemistry ; isolation & purification ; pharmacology ; Plant Extracts ; chemistry ; pharmacology ; Plant Leaves ; Plant Stems ; Rutaceae ; chemistry ; Scopoletin ; isolation & purification ; pharmacology ; Staphylococcus aureus ; drug effects

Objective To analyze the clinical feasibility of unilateral transforaminal lumbar interbody fusion (TLIF) for treating lumbar degenerative diseases by finite element method. Methods Based on CT scan data, three-dimensional (3D) finite element models of the normal L3-5 segments under physiological status (intact lumbar model), L4/5 with unilateral pedicle screw fixation plus interbody fusion (unilateral TLIF model) and L4/5 with bilateral pedicle screw fixation plus interbody fusion (bilateral TLIF model) were established by using Mimics, Pro/E, ANSYS software, respectively. Preload of 500 N and load of 10 N•m torque were applied on the superior surface of the L3 segment to simulate 5 physiological activities: body upright, flexion, extension, left lateral bending and right axial rotation. The deformation and stress distributions in vertebral body, vertebral discs, pedicle screw and cage under different loads were then recorded and analyzed to compare mechanical properties of the two fixation methods. Results The deformation of L3-5 segments fixed with unilateral TLIF or bilateral TLIF decreased as compared to the intact lumbar model; the stresses in cage reached the maximum in both unilateral TLIF model and bilateral TLIF model during back extension, meanwhile peak stresses on pedicle screws in unilateral TLIF were significantly higher than those on bilateral TILF model, with the peak stress of 463.39 MPa during back extension. ConclusionsUnilateral TLIF can be selected as a method for treating lumbar degenerative diseases; however, its stability was inferior to bilateral TLIF due to the higher peak stress. Therefore, less stretch exercises may be safe for patients during rehabilitation to avoid surgery failure or pedicle screw fracture.

The aim of this retrospective study was to quantitatively evaluate the treatment effects of intrusion of overerupted maxillary molars using miniscrew implant anchorage and to investigate the apical root resorption after molar intrusion. The subjects included 30 patients whose average ages were 35.5±9.0 years. All patients had received intrusion treatments for overerupted maxillary molars with miniscrew anchorage. There were 38 maxillary first molars and 26 maxillary second molars to be intruded. Two miniscrews were inserted in the buccal and palatal alveolar bone mesial to the overerupted molar. Force of 100-150 g was applied by the elastic chains between screw head and attachment on each side. Lateral cephalograms and panoramic radiographs taken before and after intrusion were used to evaluate dental changes and root resorption of molars. Only 6 of the 128 miniscrews failed. The first and second molars were significantly intruded by averages of 3.4 mm and 3.1 mm respectively (P<0.001). The average intrusion time was more than 6 months. The crown of the molars mesially tilted by averages of 3.1 degrees and 3.3 degrees (P<0.001) for first and second molars. The amounts of root resorption were 0.2-0.4 mm on average. The intrusion treatment of overerupted molars with miniscrew anchorages could be used as an efficient and reliable method to recover lost restoration space for prosthesis. Radiographically speaking, root resorption of molars was not clinically significant after application of intrusive forces of 200 to 300 g.
Adult ; Bone Screws ; Cephalometry ; Dental Implantation ; Female ; Humans ; Male ; Maxilla ; Middle Aged ; Molar ; diagnostic imaging ; surgery ; Orthodontic Anchorage Procedures ; instrumentation ; methods ; Radiography, Dental ; methods ; Retrospective Studies ; Root Resorption ; diagnostic imaging ; surgery ; Tooth Movement Techniques ; instrumentation ; methods ; Young Adult

Objective To explore the epidemiological status of abnormal glucose metabolism and its influential factors among middle and aged population with hypertension in Chengdu area. Methods In 2008, after adopting the methods of stratified cluster sampling, the authors investigated 4685 subjects of the middle and aged population between the age of 40-79 in Chengdu urban and rural area by checking blood pressure and oral glucose tolerance test (OGTY). Patients with previously known diabetes mellitus (DM) were only asked to perform fasting glucose and to carry out a questionnaire. Comparison of the prevalence rates of abnormal glucose metabolism in hypertensive and non-hypertensive subjects was carried out. The prevalence rates of isolated impaired glucose tolerance (I-IGT) and isolated postprandial hyperglycemia (IPH) among middle and aged subjects with hypertension were acquired and the influential factors of abnormal glucose metabolism among middle and aged subjects with hypertension were analyzed. Results The prevalence rate of abnormal glucose metabolism in the hypertensive subjects was obviously higher than that in the non-hypertensive subjects; without using OGTT, 72.9% of the pre-diubetic and 54. 4% of the new diagnosed DM patients would remain undiagnosed if fasting plasma glucose detection was used alone. Age, diabetic history of first degree relatives ,overweight or obesity were the risk factors for the development of abnormal glucose metabolism among middle and aged male subjects with hypertension in Chengdu area. Exercise training and high education level were the protective factors. Age, diabetic history of first degree relatives,abdominal obesity and hypertriglyceridemia were the risk factors for the development of abnormal glucose metabolism among middle and aged female subjects with hypertension in Chengdu area. Conclusions More than 50% of middle and aged subjects with hypertension in Chengdu area has accompanying abnormal glucose metabolism. OGTT easily discloses the abnormal status and should be a routine procedure in the diagnosis of pre-diabetes or DM in such population. Appropriate exercise, learning diabetes-related knowledge to take reasonable lifestyle, and intervention of metabolic factors such as overweight or obesity are advised. Abdominal obesity and hypertriglyceridemia play important roles in leading to abnormal glucose metabolism among middle and aged population with hypertension.